Depression can range from a mild funk to self-destructive or suicidal behavior. It's important to understand the various types of depression so you can recognize them.
Depression occurs at all ages, although major depressive episodes peak between the ages of 55 and 70 in men and 20 and 45 in women. On average, major depressive episodes last eight months, but in about 20 percent of cases, the condition may linger for two years or more. About half of those who experience an episode of major depression will have another within two years. For some people, episodes of depression are separated by several years, while others suffer groups of episodes over a short time span. Between episodes, such individuals feel well.
Major depressive disorder affects approximately 14.8 million American adults -- or 6.7 percent of the U.S. population aged 18 years and older -- in a given year. An additional 3.3 million, or about 1.5 percent of U.S. adults, suffer from a milder but longer-lasting (two years or more) form of depressions called dysthymic disorder. Major depressive disorder is more common in women than in men. Although treatment can help more than 80 percent of people with severe depression, most people with depression do not seek treatment.
Mental health professionals have categorized several types of depression, each with its own treatment. Reading the following descriptions may help you identify your situation and the treatment that is best for you:
This type of depression is a reaction to stressful events -- divorce, death of a loved one, a chronic illness, a personal tragedy, or even social isolation, which the elderly frequently experience. The person is unable to recover normally from the feelings associated with the event. Common feelings include self-pity, pessimism, and loss of interest in life. It affects people of all ages.
Seasonal Affective Disorder (SAD).
If you live in the northern latitudes and suffer depression during the winter months, you may suffer from seasonal affective disorder caused by a lack of exposure to sunlight. Doctors aren't sure exactly what physiological mechanisms are at work in SAD, but they speculate that depressed feelings and other symptoms may be due to an increase in the release of the hormone meltonin. SAD sufferers feel lethargic and irritable. They may also suffer from chronic headaches, increased appetite, weight gain, and an increased need for sleep. For unknown reasons, SAD is truly a "woman's depression," in that women make up 70 percent to 80 percent of those affected. Since about half of all SAD sufferers have relatives who also suffer from SAD or other emotional problems, researchers speculate that the problem may be inherited.
Doctors aren't sure why, but some people develop a biochemically based depression sometime during midlife. It's likely that this type of depression is caused by biochemical problems within the brain. The problem usually responds well to antidepressant medication. You may be more likely to develop this type of chemical depression if other members of your family have also suffered from this problem.
A special class of biochemical disorder is manic depression, known as bipolar disorder. The person experiences severe mood swings and intense, alternating periods of activity and despair. This requires professional intervention.
Disease or drug-related depression.
Some diseases such as AIDS, hepatitis, stroke, chronic pain, and hypothyroidism can cause depression. In hypothyroidism, the thyroid gland malfunctions, leading to too little or no thyroid hormone circulating in the bloodstream. In addition to depression, other symptoms of hypothyroidism include fatigue, weakness, weight gain, impaired memory, constipation, and shortness of breath. Fortunately, the depression and other symptoms of hypothyroidism can be effectively treated with adequate doses of thyroid hormone.
Certain drugs such as alcohol, tranquilizers, and heart and blood pressure medications, as well as withdrawal from some street drugs like cocaine, can cause drug-related depression. Some women who take birth control pills find the drugs make them irritable, anxious, and depressed. And a deficiency in some nutrients, such as folate and omega-3 fatty acid, has been linked to depression.
Recognizing depression in children is important. Depression in teenagers may appear somewhat different from adult depression. The teenage years are a period of complicated conflicts that lead many young people to develop negative self-esteem, anxieties, and fears about their future. Some young people become overwhelmed by peer pressures and feelings of isolation and powerlessness. Social expectations may be unrealistic, and doing poorly in school can lead to a feeling of rejection. The young person may have experienced a lack of support from family and other significant people and a decrease in his or her ability to cope effectively. (As is the case for adults, treatment for depression in teenagers may involve a combination of therapies.)
Special Concerns for Women
It is common for women to feel down a few days after giving birth. This is often referred to as the "baby blues." New mothers may be weepy, insecure, and confused, wondering how they could be feeling this way when they are simultaneously so happy about having had the baby. The "blues" pass in a few days. Postpartum depression, in contrast, may begin days or even weeks after a baby is born and is a potentially more serious condition.
A woman may become very withdrawn, anxious, and agitated. She may have frightening thoughts about hurting herself or her baby and may be afraid to tell anyone what she is feeling. Whenever a woman has any of these frightening feelings, she should seek help immediately. Current medical treatments for postpartum depression are very effective.
Doctors say there are several reasons why so many new mothers experience this after-pregnancy depression: a sudden shift of hormones after birth that affects one's moods; a sense of anticlimax after the excitement of pregnancy and birth; fatigue from the rigors of late pregnancy and birth; fear and insecurity about one's ability to handle the duties of motherhood; and feelings that one's horizons have shrunk, especially if the woman has previously worked outside the home.
The premenstrual period.
The mood shifts, tension, anxiety, irritability, and depression many women feel during the week or days before the onset of menstruation are related to a woman's shifting hormones. Fortunately, the dark moods of women's premenstrual periods are transitory and usually lift with the first menstrual blood. This type of cyclical depression is not related to "clinical" depression that generally requires medical intervention.
The reproductive years. There's some evidence that taking birth control pills is related to depression. Some women report feelings of anxiety, sadness, and lethargy when they use certain types of the Pill.
The menopausal years.
Menopause does not necessarily mean you're going to be plunged into depression. Research does not support that women are at greater risk for depression during menopause. However, some women do experience depressive feelings during menopause. Mental health and aging experts speculate that this may be due to negative feelings some women have about aging and loss of fertility rather than to hormonal changes.
Now that you know the various types of depression, it's time to learn about the causes of the condition. We'll cover the risk factors of depression in the next section.
This information is solely for informational purposes. IT IS NOT INTENDED TO PROVIDE MEDICAL ADVICE. Neither the Editors of Consumer Guide (R), Publications International, Ltd., the author nor publisher take responsibility for any possible consequences from any treatment, procedure, exercise, dietary modification, action or application of medication which results from reading or following the information contained in this information. The publication of this information does not constitute the practice of medicine, and this information does not replace the advice of your physician or other health care provider. Before undertaking any course of treatment, the reader must seek the advice of their physician or other health care provider.